Off-label PDT protocols show promise in AK treatment

Maria M. Tsoukas, M.D., Ph.D.Photodynamic therapy (PDT) with 20% aminolevulinic acid (ALA; Levulan Kerastick, DUSA) and blue light (BLU-U, DUSA) is a useful option for treating actinic keratoses (AK) of the face and scalp, according to one expert. The therapy provides high clearance rates with excellent cosmetic outcomes when performed using the FDA-approved directions, said Maria M. Tsoukas, M.D., Ph.D., associate professor, department of dermatology, University of Illinois College of Medicine, Chicago.

Modified protocols are being looked at, however, and are showing promise for improving treatment convenience and reducing cost while maintaining or enhancing initial and longer-term outcomes, she told colleagues Saturday, March 5 at the 74th Annual Meeting of the American Academy of Dermatology.

The protocol for PDT that is approved in the United States is a five-step process that includes an ALA incubation period of 14 to 18 hours (although a shorter incubation time of two to three hours has showed similar efficacy), and it often requires one or two additional sessions performed at intervals of three to four weeks to optimize the outcome, Dr. Tsoukas says.

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